Development of Academic Procrastination Model for Nursing Students at Institute of National Importance: Expanding Horizons in Nursing Education

Abstract

Aim:

This study statistically assessed the predictive as well as outcome variables of academic procrastination among nursing students to develop an “Academic Procrastination Model for Nursing Students.”

Methods:

A descriptive cross-sectional research design was used to collect data from 436 college nursing students of an institute of national importance in Northern India through total enumeration sampling from 4th April to 20th April 2025. Procrastination assessment scale, perceived stress scale, academic anxiety scale, and academic performance assessment, etc. tools were used to collect data. Informed consent was taken and confidentiality was maintained. Descriptive (mean ± SD, frequency/percentage) and inferential statistics (independent t-test, one-way analysis of variance test, chi-square/Fisher’s Exact test, Pearson’s correlation coefficient, multiple linear regression, and generalized linear regression model) were used for analysis.

Results:

A total of 436 participants were included in the study, with a mean age of 22.19 ± 3.33 years. The majority were female (97%), 76.1% were enrolled in Basic B.Sc. Nursing, and 67.8% belonged to the middle class. The mean PASS score was 51.64 ± 12.52, indicating a moderate level of academic procrastination. High procrastination was observed in writing term papers (47.7%) and studying for examinations (46.8%). No significant association was found between socio-demographic variables and procrastination (p > .05). Multiple linear regression analysis revealed that yoga/meditation, morning self-study, screen time, peer pressure, and lack of motivation were significant predictors of academic procrastination (p < .05). Higher procrastination was significantly associated with increased perceived stress and academic anxiety (p < .05), and decreased academic performance and self-efficacy (p < .05). Participants suggested several strategies to reduce procrastination, including interdisciplinary research opportunities (88.1%), mental and physical health education (86.9%), individualized counselling and coaching (85.6%), and digital wellbeing strategies (83.5%).

Conclusion:

Based on study findings, an “Academic Procrastination Model for Nursing Students” was developed to emphasize healthy behaviors, time management, and stress reduction, as conventional strategies may be insufficient.

What is already known on this topic?

• Academic procrastination is a common behavioral problem among students that negatively affects learning outcomes and academic success.

• It is often associated with higher levels of stress, anxiety, and reduced academic performance.

• Various personal, psychological, and environmental factors contribute to procrastination among nursing students.

• Traditional interventions, like time management and motivation training, have shown limited effectiveness in addressing this issue comprehensively.

What this study adds on this topic?

• This study identifies key predictive and outcome variables of academic procrastination among nursing students and develops an evidence-based “Academic Procrastination Model for Nursing Students.”

• It highlights the protective role of yoga/meditation and morning self-study habits in reducing procrastination.

• The model emphasizes interdisciplinary research, individualized counseling, and digital well-being strategies as innovative approaches to enhance self-efficacy, reduce stress, and improve academic performance among nursing students.

Introduction

Academic procrastination is a pervasive behavioral phenomenon characterized by the intentional delay of academic tasks despite awareness of potential negative consequences. It is widely conceptualized as a self-regulatory failure involving cognitive, emotional, and behavioral components, often linked to low self-efficacy, poor time management, and reduced motivation (Kim & Seo, 2015; Klassen et al., 2008). Contemporary literature highlights that procrastination is not merely a time-management issue but a complex psychological construct with significant academic and mental health implications (González-Brignardello et al., 2023).

Academic procrastination is highly prevalent among students, particularly in health-related disciplines. Recent studies indicate that a substantial proportion of healthcare students experience habitual procrastination (Ahmed et al., 2023; Rezaei-Gazki et al., 2024). Among nursing students, the prevalence is even higher, with evidence suggesting moderate to high levels of procrastination (Ahmed et al., 2023; Cao et al., 2025; Li et al., 2023). This high prevalence emphasizes the importance of examining procrastination within nursing education.

Multiple interrelated factors contribute to academic procrastination. Recent evidence identifies low self-efficacy, lack of motivation, peer influence, and excessive digital engagement (screen time) as key determinants (Ali et al., 2024; Li et al., 2023; Sujadi & Sulistiyo, 2025). Psychological factors such as stress, anxiety, and poor coping mechanisms further exacerbate procrastination behaviours(Cao et al., 2025; Malvi et al., 2025; Rezaei-Gazki et al., 2024). Additionally, environmental and lifestyle factors including academic workload and distractions play a significant role (Negm et al., 2024). Emerging research also highlights the role of mindfulness and behavioral interventions in reducing procrastination (Gagnon et al., 2019).

The consequences of academic procrastination are substantial and multidimensional. It has been consistently associated with increased perceived stress, heightened academic anxiety, reduced academic performance, and lower psychological well-being (Cao et al., 2025; Kim & Seo, 2015; Malvi et al., 2025; Rezaei-Gazki et al., 2024). Procrastination can impair learning efficiency and negatively affect academic outcomes while undermining essential professional competencies.

Nursing students face unique academic and clinical demands, including intensive coursework, clinical training, and high expectations for competence. These challenges require strong self-discipline and effective time management. However, procrastination in this population has been linked to increased stress, emotional instability, and reduced academic and professional preparedness (Ahmed et al., 2023; Negm et al., 2024). Persistent procrastination may also compromise clinical readiness and patient safety.

Despite the growing body of literature, most studies focus on isolated predictors or outcomes of procrastination. There remains a need for comprehensive, integrative models that examine the interplay between behavioral, psychological, and lifestyle factors, particularly among nursing students in the Indian context.

Therefore, the present study aims to identify the predictive and outcome variables of academic procrastination among nursing students and to develop an evidence-based “Academic Procrastination Model for Nursing Students.”

Research Question

1. Which factors independently predict academic procrastination and how can these findings be integrated into an evidence-based Academic Procrastination Model for Nursing Students?

Methods

Study Design

A descriptive cross-sectional study was conducted.

Sample

The study was conducted among 436 nursing students enrolled at an Institute of National Importance in Northern India. A total enumeration sampling technique was used to include all eligible and willing participants during data collection period from 4th April to 20th April 2025. Based on a previous study (Saikia & Aktar, 2024), 41% of students exhibited a high degree of academic procrastination. Using these findings, the required sample size for the present study was calculated to be 372 with 5% marginal error and 95% confidence interval. Considering a 10% non-response rate, the target was set at 415 participants. Ultimately, to ensure adequate representation, a total of 436 participants were recruited.

Sample size calculation using Cochran’s Formula:

Here, Z = 1.96 at 95% confidence interval, p = 18% = 0.18, d = 5% = 0.05

Ethical Considerations

Ethical approval was obtained from the Ethics Committee of NINE, PGIMER, Chandigarh (Approval No. EC/NINE/Post-Basic/2025/GROUP-2; dated 11 March 2025). After obtaining informed written consent, participants were briefed about the purpose of the study and then requested to complete the questionnaires. This study used ChatGPT to improve language and edit grammar, during the preparation of the manuscript. Standardized tools were used after obtaining permission from the respective authors, including a socio-demographic profile sheet, Procrastination Assessment Scale-Students (PASS), Perceived Stress-Scale (PSS), Academic Anxiety-Scale (AAS), and Academic Performance Assessment Scale (APAS).

Procedure for Data Collection

The researchers commenced the study by explaining its purpose, benefits, and procedures to the participants. Data were collected through face-to-face interactions, with each participant requiring approximately 8–10 minutes to complete the data collection process. Informed consent was then obtained, with participants signing the consent forms before taking part in the study. Socio-demographic data were collected using the self-structured and validated questionnaire. Following this, participants completed the Procrastination Assessment Scale for Students (PASS) following clear instructions. The Academic Anxiety Scale (AAS) was administered with detailed explanations to ensure proper understanding, followed by the Perceived Stress Scale (PSS). Finally, the APAS was used to collect the summative percentage of academic performance of the previous academic years. Measures or suggestions to improve academic procrastination among nursing students were assessed using an open-ended questionnaire. The participants were asked to write down their suggestions or opinion in four to five sentences for the same. A pilot study was conducted among 50 participants to assess the feasibility, validity, and reliability of the study tools.

Data Collection Tools

Socio-Demographic Profile Sheet

This 12-item tool collected background details such as age, gender, religion, family type, marital status, academic course, type of board, socio-economic status as per modified BG Prasad scale-2023, physical lifestyle exercises whether the participants were doing yoga/meditation, morning/evening walk, gym, sports activity, and their time duration, self-study time (early morning, evening, and late night), screen time, and health status or any comorbidity among participants. The tool was validated by experts for clarity and content, ensuring its appropriateness for the study.

Procrastination Assessment Scale-Students

Developed by Solomon and Rothblum (1984), PASS consists of 44 items divided into three sections. The first section (18 items) assesses procrastination in six academic domains (writing papers, preparing for exams, readings, administrative tasks, meetings, and academic tasks) using a 5-point Likert scale for frequency, perceived problems, and willingness to reduce procrastination. The second section, with 26 items (from 19–44 items), evaluates reasons for procrastination on a 5-point Likert scale (1 = not at all reflects why I procrastinated, 2–4 = somewhat reflects, and 5 = definitely reflects why I procrastinated), yielding a score between 26 and 130. With expert opinion for further analysis, the reasons for procrastination items were sub-grouped into four domains such as:

1. Lack of motivation - Items 27,

2. Peer Pressure/Peer Influence - Items 21,

3. Self-pressure/Fear of failure - Items 19,

4. External/situational barriers - Items 20.

The third section includes Students’ Self-Efficacy Scale developed by Bashir et al. (2019), containing 20 items rated on a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree), yielding a score between 20 and 100. A pilot study was conducted on 50 participants to assess the reliability and internal consistency of the tools. Cronbach’s α values were 0.922 for academic domains, 0.944 for reasons of procrastination, and 0.892 for students’ self-efficacy. In the current study, Cronbach’s α values were 0.901 for academic domains, 0.873 for reasons of procrastination, and 0.783 for students’ self-efficacy—all above the acceptable standard of 0.80. Previous studies have also reported high internal consistency, with α values ranging from 0.79 to 0.90 (Solomon & Rothblum, 1984).

Perceived Stress Scale

Perceived Stress Scale (PSS-10) was developed by Sheldon Cohen, Tom Kamarck, & Robin Mermelstein in 1983 to measure stress experienced during the past month. It has ten items rated on a 5-point Likert scale ranging from 0 (never) to 4 (very often) (Harris et al., 2023).Cronbach’s α in the pilot study was 0.890 and in the current study was 0.781, demonstrating good reliability. Prior research also supports excellent reliability with α values between 0.78 and 0.91 (Harris et al., 2023).

Academic Anxiety Scale

Academic Anxiety Scale was developed by Jerrell C. Cassady & colleagues in 2019. This scale includes 11 items rated on a 4-point scale, assessing the level of anxiety related to academic performance. The pilot study found a Cronbach’s α of 0.911 and 0.899 in the current study, while previous reports indicated 0.82, reflecting good consistency (Cassady et al., 2019).

Academic Performance Assessment Scale

This validated, self-structured tool (developed by the investigators) collected objective academic data, including students’ names, classes, summative marks, and percentage scores. The inter-rater reliability of the tool was 0.965. APAS was validated by education and nursing experts to check the content appropriateness, clarity, and relevance. Changes were made as per the suggestions given by the experts. The APAS was considered reliable as it was based on objective institutional records.

Measures or Suggestions to Improve Academic Procrastination Among Nursing Students

This section included open-ended responses from participants regarding measures or suggestions to reduce academic procrastination among nursing students. The question was framed as follows: “In your opinion, what measures or strategies can help reduce academic procrastination among nursing students?” The content validity of this open-ended question was evaluated by experts in the fields of nursing, psychology, and education.

Statistical Analysis

The statistical analysis was performed using SPSS for Windows, version 22.0 (IBM SPSS Corp.; Armonk, NY, USA). The normality of quantitative data—including age, PASS scores, PSS scores, AAS scores, APAS scores, and screen time in hours—was assessed using the Shapiro-Wilk test. Data following a normal distribution were presented as mean ± SD. Categorical variables such as gender, religion, type of family, course of study, marital status, exercise habits, self-study time, socioeconomic status, co-morbidities, and item-wise responses from PASS, PSS, AAS, and APAS scales were summarized as frequencies and percentages. For inferential analysis, the independent t test (for two subgroups and one-way ANOVA (for more than two subgroups) were applied to compare mean differences in procrastination scores between groups. Categorical variables were compared using the Chi-square test. When more than 25% of cells had expected frequencies below five, Fisher’s Exact test was used to ensure accuracy. Pearson’s correlation coefficient was employed to explore associations between PASS, PSS, AAS, screen time, and APAS scores. Multiple linear regression was applied to identify independent predictors of PASS among the participants. A generalized linear regression model was applied to assess the impact of PASS on self-efficacy, PSS, AAS, and academic performance. A p-value of less than 0.05 was considered statistically significant, indicating that the probability of the result occurring by chance was less than 5%. All findings were reported with a 95% confidence interval. The responses of measures or suggestions to improve academic procrastination among nursing students were analyzed using a thematic content analysis approach. All responses were reviewed independently by two authors, and recurring ideas were coded into categories. These categories were then grouped into broader themes. The frequency of each theme was calculated and expressed as percentages to reflect how commonly each suggestion was reported among participants.

Results

Mean age of the participants was 22.19 ± 3.32 years. Most (97.0%) were females, the majority (78.9%) were Hindu. Three-fourths (75.2%) belonged to nuclear families, and a similar proportion (76.1%) were pursuing Basic B.Sc. Nursing, 64.7% were from CBSE board, 95.4% were unmarried, 66.1% were from urban areas, 75.9% were residing in hostels during data collection, and 67.8% belonged to middle socioeconomic class. None of the socio-demographic variables—age, gender, religion, family type, course, educational board, marital status, living locality, residence type, or socioeconomic status showed a significant association with academic procrastination (p > .05). There was also no significant correlation between age and PASS scores among participants (r = .068; p = .158) (Table 1).

Table 1.

Comparison of Procrastination Assessment Scale-Student (PASS) Score with Socio-demographics of the study participants (N = 436)

Variables	n (%)	PASS Score (Mean ± SD)	p
Age in years
Mean ± SD (range)	22.19 ± 3.32 (18–46)	r = .068	.158a
≤ 20	128 (29.3)	51.39 ± 11.59	.817b
21-25	261 (59.9)	51.57 ± 12.59
>25	47 (10.8)	52.72 ± 14.59
Gender
Female	423 (97.0)	51.52 ± 12.51	.220c
Male	13 (03.0)	55.84 ± 12.67
Religion
Hindu	344 (78.9)	51.76 ± 12.83	.862b
Sikh	65 (14.9)	51.55 ± 11.02
Others (Muslim/Christian/Buddhism/Jainism)	27 (06.2)	50.40 ± 12.27
Type of family
Nuclear	328 (75.2)	51.18 ± 12.61	.179c
Joint	108 (24.8)	53.05 ± 12.19
Course
Basic BSc Nursing	332 (76.1)	51.78 ± 12.40	.704b
Post Basic BSc Nursing	56 (12.8)	50.37 ± 11.98
Postgraduate Nursing	48 (11.0)	52.16 ± 14.04
Type of Board
CBSE	282 (64.7)	51.80 ± 12.35	.405b
ICSE	11 (02.5)	56.09 ± 11.37
State board	143 (32.8)	51.00 ± 12.92
Marital status
Married	20 (04.6)	54.60 ± 16.38	.281c
Unmarried	416 (95.4)	51.50 ± 12.31
Living locality
Urban	288 (66.1)	51.90 ± 12.74	.265b
Rural	112 (25.7)	50.26 ± 12.46
Semi urban	36 (08.3)	53.91 ± 10.61
Present resident
Hosteller	331 (75.9)	51.87 ± 12.48	.508c
Day scholar	105 (24.1)	50.94 ± 12.65
Socioeconomic status (Modified BG Prasad Scale -2023)
Upper class - ₹9098 and above	21 (04.8)	48.28 ± 16.75	.648b
Upper middle class -₹4549–9097	117 (26.8)	52.03 ± 12.34
Middle class - ₹2729–4548	294 (67.8)	51.72 ± 12.22
Lower middle class - ₹1364–2728	4 (0.9)	52.50 ± 17.13
Lower class < ₹1364	0	–

^aPearson’s correlation test; ^bOne-way ANOVA test ; ^cIndependent t-test.

Mean PASS score was 51.75 ± 12.82 among participants with comorbidities and 51.63 ± 12.50 among those without comorbidity, showing no significant difference in mean scores (p = .954). Mean PASS scores by type of comorbidity were as follows: diabetes mellitus (51.25 ± 9.74), hypertension (59.20 ± 9.12), polycystic ovary syndrome (57.66 ± 14.84), polycystic ovarian disease (47.75 ± 10.33), migraine (49.80 ± 12.73), and thyroid disorders (43.00 ± 19.84) and other conditions such as systemic lupus erythematosus or allergic rhinitis (58.83 ± 10.02). There was no significant difference among these groups (Table 2).

Table 2.

Comparison of Procrastination Assessment Scale-Students (PASS) Score and Comorbidity Among Study Participants (N = 436)

Comorbidity	n (%)	PASS Score (Mean ± SD)	p
Any comorbidity	41 (9.4)	51.75 ± 12.82	.954a
No comorbidity	395 (90.6)	51.63 ± 12.50
Type of comorbidity
Diabetes mellitus	4 (0.9)	51.25 ± 9.74	.345b
Hypertension	5 (1.1)	59.20 ± 9.12
Polycystic ovary syndrome (PCOS)	3 (0.7)	57.66 ± 14.84
Polycystic ovarian disease (PCOD)	8 (1.8)	47.75 ± 10.33
Migraine	10 (2.3)	49.80 ± 12.73
Hypo/hyperthyroidism	5 (1.1)	43.00 ± 19.84
Others (SLE/allergic rhinitis)	6 (1.4)	58.83 ± 10.02

^aIndependent t test; ^bone-way ANOVA test.

A statistically significant association was observed for students practicing yoga or meditation (p = .001). Those who engaged in yoga/meditation reported markedly lower mean procrastination scores (47.59 ± 11.43) compared to students who did not do yoga/meditation (52.88 ± 12.59). Similarly, students who preferred morning study sessions had significantly lower procrastination levels (49.80 ± 12.18) than those who studied later in the day (52.85 ± 12.61; p = .013). Other physical activities such as morning or evening walks (p = .187), running or jogging (p = .897), participation in sports (p = .175), or gym workouts (p = .269) did not show statistically significant differences in procrastination scores. Similarly, no significant association was found with evening (p = .086) or late-night study patterns (p = .943) (Table 3).

Table 3.

Comparison of Procrastination Assessment Scale-Students (PASS) Score with Physical or Mental Exercise and Self-Study Timing (N = 436)

Variables	PASS Score (Mean ± SD)	p (Independent t-test)
Yoga/meditation
Yes (n = 102)	47.59 ± 11.43	.001
No (n = 334)	52.88 ± 12.59
Morning/evening walk
Yes (n = 385)	51.36 ± 12.09	.187
No (51)	53.82 ± 15.33
Running/jogging
Yes (n = 77)	51.48 ± 11.76	.897
No (n = 359)	51.68 ± 12.69
Sports
Yes (n = 51)	49.41 ± 12.11	.175
No (n = 385)	51.94 ± 12.56
Gym
Yes (n = 16)	48.25 ± 11.04	.269
No (n = 420)	51.77 ± 12.56
Morning time self-study
Yes (n = 173)	49.80 ± 12.18	.013
No (n = 263)	52.85 ± 12.61
Evening time self-study
Yes (n = 318)	51.02 ± 12.79	.086
No (n = 118)	53.33 ± 11.63
Late night time self-study
Yes (n = 232)	51.68 ± 12.79	.943
No (n = 204)	51.60 ± 12.23

A total of 208 (47.7%) students reported procrastinating “sometimes,” 190 (43.6%) found it problematic, and 140 (32.1%) wanted to change. For exams, 204 (46.8%) procrastinated, 170 (39%) saw it problematic, and 112 (25.7%) wished to reduce it. In reading-related tasks, 188 (43.1%) reported procrastination, 196 (45%) viewed it as problematic, and 167 (38.3%) wanted to improve. For administrative tasks, 133 (30.5%) procrastinated, 146 (33.5%) found it problematic, and 111 (25.5%) expressed a desire to change. Regarding attendance: 144 (33%) procrastinated, 157 (36%) found it problematic, and 141 (32.3%) desired improvement. For academic activities: 163 (37.4%) procrastinated, 173 (39.7%) considered it problematic, and 126 (28.9%) wished to overcome it. Overall, procrastination was frequent, often seen as problematic, with many expressing a willingness to overcome (Table 4).

Table 4.

Item-Wise Analysis of Academic Procrastination Among Study Participants Assessed by Procrastination Assessment Scale-Students (PASS)

Variables	Procrastination Assessment Scale-Students (PASS)
	Never n (%)	Almost Never n (%)	Sometimes n (%)	Nearly Always n (%)	Always n (%)
1. Writing a Term Paper
To what degree do you procrastinate on this task?	65 (14.9)	72 (16.5)	208 (47.7)	59 (13.5)	32 (07.3)
To what degree is procrastination on this task a problem for you?	62 (14.2)	91 (20.9)	190 (43.6)	65 (14.9)	28 (06.4)
To what extent do you want to decrease your tendency to procrastinate on this task?	45 (10.3)	64 (14.7)	140 (32.1)	81 (18.6)	106 (24.3)
2. Studying for Exams
To what degree do you procrastinate on this task?	47 (10.8)	66 (15.1)	204 (46.8)	88 (20.2)	31 (07.1)
To what degree is procrastination on this task a problem for you?	39 (08.9)	103 (23.6)	170 (39.0)	94 (21.6)	30 (06.9)
To what extent do you want to decrease your tendency to procrastinate on this task?	44 (10.1)	77 (17.7)	112 (25.7)	109 (25)	94 (21.6)
3. Keeping Up with Reading Assignments
To what degree do you procrastinate on this task?	45 (10.3)	85 (19.5)	188 (43.1)	85 (19.5)	33 (7.6)
To what degree is procrastination on this task a problem for you?	57 (13.1)	71 (16.3)	196 (04.5	82 (18.8)	30 (6.9)
To what extent do you want to decrease your tendency to procrastinate on this task?	45 (10.3)	67 (15.4)	167 (38.3)	76 (17.4)	81 (18.9)
4. Academic Administrative Tasks: Filling Out Forms, Registering for Classes, Getting ID Cards, etc.
To what degree do you procrastinate on this task?	80 (18.3)	112 (25.7)	133 (30.5)	78 (17.9)	33 (07.6)
To what degree is procrastination on this task a problem for you?	82 (18.8)	109 (25.0)	146 (33.5)	75 (17.2)	24 (05.5)
To what extent do you want to decrease your tendency to procrastinate on this task?	85 (19.5)	92 (21.1)	111 (25.5)	89 (20.4)	59 (13.5)
5. Attendance Tasks: Meeting with Your Advisor, Making an Appointment with a Professor, etc.
To what degree do you procrastinate on this task?	87 (20.0)	113 (25.9)	144 (33.0)	67 (15.4)	25 (05.7)
To what degree is procrastination on this task a problem for you?	81 (18.6)	117 (26.8)	157 (36.0)	61 (14.0)	20 (04.6)
To what extent do you want to decrease your tendency to procrastinate on this task?	78 (17.9)	92 (21.1)	141 (32.3)	62 (14.2)	63 (14.4)
6. School Activities in General
To what degree do you procrastinate on this task?	57 (13.1)	118 (27.1)	163 (37.4)	79 (18.1)	19 (04.4)
To what degree is procrastination on this task a problem for you?	66 (15.1)	129 (29.6)	173 (39.7)	59 (13.5)	9 (02.1)
To what extent do you want to decrease your tendency to procrastinate on this task?	66 (15.1)	113 (25.9)	126 (28.9)	77 (17.7)	54 (12.4)

The mean PASS score was 51.64 ± 12.52, indicating a moderate level of academic procrastination among the participants. For predictive variables, the average screen time was 4.52 ± 1.84 hours/day. The mean scores for reasons of procrastination were: peer pressure (9.75 ± 3.15), lack of motivation (15.94 ± 4.83), self-pressure or fear of failure (17.04 ± 5.24), and external or situational barriers (23.18 ± 6.05). For outcome variables, the mean perceived stress score was 21.55 ± 5.35, indicating moderate stress related to academic workload. Mean academic anxiety score was 20.69 ± 7.37, mean self-efficacy score was 70.27 ± 8.22, and mean academic performance was 67.73 ± 7.67% among the participants (Table 5).

Table 5.

Descriptive Statistics of Independent, Predictive and Outcome Variables Among Study Participants

Predictive Variables	(Mean ± SD)	Outcome Variables	(Mean ± S)
PASS score	51.64 ± 12.52	Perceived stress score	21.55 ± 5.35
Screen time (in hours)	4.52 ± 1.84	Academic anxiety score	20.69 ± 7.37
Peer pressure	9.75 ± 3.15	Academic performance (in percentage)	67.73 ± 7.67
Lack of motivation	15.94 ± 4.83	Self-efficacy	70.27 ± 8.22
Self-pressure or fear of failure	17.04 ± 5.24
External or situational barriers	23.18 ± 6.05

The correlation analysis between PASS scores and various predictive and outcome variables revealed several statistically significant associations, highlighting the multifactorial nature of academic procrastination among nursing students. A moderate positive correlation was observed between screen time and procrastination (r = .309, p = .001), indicating that higher daily screen usage was linked with increased procrastination tendencies. Similarly, peer pressure (r = .270, p = .001) and lack of motivation (r = .249, p = .001) were both significantly and positively correlated with procrastination. A weak but significant positive correlation was also found between procrastination and self-pressure or fear of failure (r = .158, p = .001). Moreover, external or situational barriers such as environmental distractions or competing responsibilities showed a positive relationship (r = .212, p = .001). In terms of psychological outcomes, procrastination demonstrated a significant positive correlation with perceived stress (r = .205, p = .001) and academic anxiety (r = .235, p = .001). These findings indicate that students who procrastinate more tend to experience elevated levels of stress and anxiety. Conversely, self-efficacy showed a negative correlation (r = −.192, p = .001), suggesting that students with stronger confidence in their abilities are less likely to procrastinate. Likewise, academic performance showed a weak but significant negative association (r = −.110, p = .022), indicating that higher procrastination modestly correlates with lower academic achievement (Figure 1).

Figure 1.

Correlation of PASS Score with Predictor and Outcome Variables.

Multiple linear regression analysis was performed to identify the independent predictors of academic procrastination, as measured by the PASS. The model revealed that several behavioral and psychological variables significantly contributed to variations in procrastination scores among nursing students. Among the predictors, screen time emerged as the strongest positive predictor (B = 1.78, SE = 0.30, p < .001), indicating that each additional hour of daily screen use was associated with a notable rise in procrastination levels. Similarly, peer pressure (B = 0.52, SE = 0.24, p = .029) and lack of motivation (B = 0.31, SE = 0.14, p = .026) were significant positive predictors, suggesting that students who experienced greater social or motivational challenges were more likely to delay academic tasks. Conversely, two variables—yoga/meditation (B = −3.06, SE = 1.33, p = .022) and morning study habits (B = −2.64, SE = 1.13, p = .020) were significant negative predictors of procrastination. This indicates that students who practiced yoga or meditation and those who preferred studying in the morning were less likely to procrastinate, emphasizing the protective role of mindfulness practices and structured study routines in reducing academic delay. Other predictors, including self-pressure or fear of failure (B = −0.01, p = .985) and external or situational barriers (B = 0.16, p = .275), were not statistically significant, suggesting that although they may influence procrastination behavior, their independent effects were minimal after controlling for other factors. The Variance Inflation Factor (VIF) values for all predictors ranged from 1.04 to 2.54, confirming the absence of multi-collinearity and ensuring the reliability of the model estimates (Table 6A).

Table 6.

Part A: Multiple Linear Regression to Find Out Independent Predictors of PASS Among the Participants

Predictors of PASS Score	Beta Coefficient (B)	Standard Error of B	p	Collinearity Statistics
				Tolerance	VIF
Yoga/meditation	−3.06	1.33	.022	0.93	1.08
Morning time study	−2.64	1.13	.020	0.97	1.04
Screen time (in hours)	1.78	0.30	.000	0.95	1.05
Peer pressure	0.52	0.24	.029	0.53	1.88
Lack of motivation	0.31	0.14	.026	0.67	1.50
Self-pressure or fear of failure	−0.01	0.14	.985	0.55	1.80
External/situational barriers	0.16	0.14	.275	0.39	2.54
Constant	31.82	2.76	.001

The linear regression analysis was conducted to evaluate the predictive impact of academic procrastination (PASS score) on perceived stress, academic anxiety, academic performance, and self-efficacy among nursing students. The findings suggested that procrastination had a significant influence on all four outcome variables, highlighting its broad psychological and academic consequences. A significant positive relationship was observed between procrastination and perceived stress (B = 0.09, SE = 0.02, p = .001), indicating that higher levels of procrastination were associated with increased stress. Similarly, a strong positive association was found between procrastination and academic anxiety (B = 0.14, SE = 0.03, p = .001), suggesting that delays in academic tasks were linked with elevated anxiety regarding academic performance and expectations. In contrast, procrastination showed a significant negative relationship with both academic performance (B = −0.067, SE = 0.03, p = .022) and self-efficacy (B = −0.13, SE = 0.03, p = .001). This implies that higher procrastination tendencies corresponded with lower academic achievement and self-efficacy (Table 6B).

Table 6.

Part B: Generalized Linear Regression Model to Assess the Impact of Pass on Self-efficacy, PSS, AAS, and Academic Performance Among the Participants

(Independent Variable: PASS Score) Outcome Variables	β coefficient (B)	Standard Error of B	p
Perceived stress score	0.09	0.02	.001
Academic anxiety score	0.14	0.03	.001
Academic performance (in %)	−0.07	0.03	.022
Self-efficacy score	−0.13	0.03	.001

Development of Academic Procrastination Model for Nursing Students

Based on the findings of the multivariate generalized linear regression model, an “Academic Procrastination Model for Nursing Students” was proposed. This model explains the factors influencing academic procrastination among nursing students. Key predictors include yoga/meditation and morning study habits, which significantly reduced procrastination, while increased screen time, peer pressure, and lack of motivation were associated with higher procrastination levels. Academic procrastination, in turn, increased perceived stress and academic anxiety, while lowering academic performance and self-efficacy. To mitigate procrastination, the model recommends strategies such as interdisciplinary research (88.1%), mental and physical health education (86.9%),individualized counselling and coaching (85.6%), and digital wellbeing strategies (83.5%).Overall, the model emphasizes a holistic approach integrating mental health, motivation, and learning habits (Figure 2).

Figure 2.

Academic Procrastination Model for Nursing Students.

Discussion

The present study highlights the key factors influencing academic procrastination among nursing students, emphasizing the roles of psychological, behavioral, and lifestyle variables. Findings indicate that students who engage in yoga or meditation and maintain a morning study routine show lower levels of procrastination. In contrast, increased screen time, peer pressure, and lack of motivation are significant predictors of higher procrastination levels.

Relationship of Socio-Demographics with Academic Procrastination

In the current study, the age of the participants showed no association with procrastination. Recent evidence also supports this observation, indicating that procrastination tendencies are relatively stable across student populations. No gender differences were observed, aligning with Saxena et al. (Saxena & Chandra, 2024) suggesting that procrastination is not gender-dependent.

No significant association was found between religious affiliation and procrastination, which is in line with a previous study (Sujadi & Sulistiyo, 2025). Family structure also showed no effect on procrastination, supported by Saxena et al. (Saxena & Chandra, 2024). No association was found with the type of education board, echoing the findings of Ahmed et al. (Ahmed et al., 2023). Marital status showed no relationship with procrastination, consistent with Hussain et al. (Hussain et al., 2023). Likewise, living locality (urban/rural) was not linked to procrastination, aligning with Saxena et al. (Saxena & Chandra, 2024). Finally, the residence type (hosteller/day scholar) also showed no association, consistent with a previous study (Chakraborty et al., 2022).

Recent literature further supports that demographic variables have limited influence compared to psychological and behavioral factors in predicting procrastination (Nie et al., 2025).

Relationship of Physical/Mental Exercises and Self-study Time with Academic Procrastination

In the present study, 102 out of 436 participants reported doing routine yoga/meditation, and 385 out of 436 were reported doing morning/evening walks. Yoga, as a mind–body practice, improves mindfulness, self-control, confidence, and focus, reducing stress and helping in combating procrastination. In this study, engagement in yoga/meditation was significantly associated with decreasing procrastination (p = .001). These findings are supported by recent studies showing that mindfulness significantly reduces academic procrastination by improving emotional regulation and cognitive control (Yue et al., 2024). Similarly, recent research highlights that perceived stress and emotional instability are positively correlated with procrastination behaviors, reinforcing the psychological basis of procrastination(Rad et al., 2025). Morning study time also showed a significant association (p = .013), with morning study linked to lower procrastination. A significant number studied in the evening (n = 318) or late-night hours (n = 232), showing a preference for delayed study hours. A weak positive correlation (r = .31, p = .001) was found between procrastination and screen time, suggesting that higher screen time is associated with increased procrastination. Recent literature supports that excessive digital use and poor self-regulation contribute significantly to procrastination behaviors among students (Albursan et al., 2022).

Relationship of Comorbidities with Academic Procrastination

Any comorbidity was reported by 9.4% of participants, with migraine (2.3%) and PCOD (1.8%) being the main findings. In the current study, there was no significant relationship between comorbidity and academic procrastination. Recent studies suggest that while comorbidities may not directly influence procrastination, they may indirectly affect it through stress, fatigue, and reduced cognitive functioning (Xue & Abdullah, 2025).

Item-Wise Analysis of Academic Procrastination

High procrastination was noted in writing term papers (47.7%) and preparing for exams (46.8%). Despite recognizing procrastination as a problem, the results suggest a moderate level of academic delay overall. Recent studies continue to report similar patterns, indicating that students are more likely to procrastinate on complex and evaluative academic tasks (Benlahcene et al., 2026). In this study, the mean PASS score was 51.64 ± 12.52, signifying more than half of the participants having academic procrastination.

Relationship of Academic Procrastination with Outcome Variables

In this study, there was a weak positive correlation between procrastination and perceived stress (p < .001). Recent studies also confirm that procrastination is strongly associated with higher stress levels and poorer psychological outcomes (Xue & Abdullah, 2025). A significant correlation was found between procrastination and academic performance (p < .05), suggesting higher procrastination lowers academic achievement. A mild positive correlation (r = .23, p < .01) was noted between procrastination and anxiety. Contemporary findings indicate that anxiety and procrastination are closely interlinked behavioral constructs (Nie et al., 2025). In current research, a weak negative correlation was found between procrastination and self-efficacy (r = −.19, p = .001). Recent studies confirm that self-efficacy and emotional regulation are key predictors of procrastination (Rad et al., 2025). Based on these findings, this study recommends several strategies to mitigate procrastination, including mental and physical health education, digital well-being programs, personalized counseling and coaching, and interdisciplinary research engagement. Recent evidence also supports the effectiveness of internet-based and mindfulness-based interventions in reducing procrastination among students(Amarnath et al., 2025; Kakade, 2025).

Development of Academic Procrastination Model for Nursing Students

Based on the findings from multivariate and generalized linear regression analyses, an Academic Procrastination Model for Nursing Students was developed, as shown in Figure 2. Recent literature supports that academic procrastination is a multifactorial construct influenced by cognitive, emotional, and behavioral factors (Rad et al., 2025).

Study Limitations

Although this study provides important insights, several limitations should be acknowledged.

First, the cross-sectional design limits the ability to determine causal relationships among the variables. Future research using longitudinal or experimental designs could better clarify these relationships over time.

Second, the proposed model is preliminary and hypothesis generating, rather than definitive. It is explicitly stated that the findings are based on a single-center sample and may have limited generalizability.

Third, the sample was restricted to a single group of nursing students, limiting generalizability to other populations. Comparative studies involving students from various disciplines and regions would enhance the external validity of these findings.

Despite these limitations, the findings provide a valuable foundation for future intervention-based research. Programs should focus on integrating mindfulness training, digital well-being awareness, and personalized counseling into nursing education. Embedding such initiatives within the nursing curriculum may help students strengthen self-regulation, manage stress more effectively, and enhance academic performance.

It is emphasized the need for multi-center studies with larger and more diverse populations, as well as longitudinal or experimental designs, to validate and refine the proposed model.

Note: Item-wise analysis of PSS, AAS, Reasons of academic procrastination and Student Self-efficacy scale are given in Supplementary Tables 1 to 4.

Supplementary Table 1.

Item-wise analysis of Perceived Stress among Study Participants assessed by Perceived Stress Scale (PSS)

Items	Perceived Stress Scale (PSS)
	Never n (%)	Almost never n (%)	Sometimes n (%)	Fairly often n (%)	Very often n (%)
In the last month, how often have you been upset because of something that happened unexpectedly?	42((09.6)	35(08.0)	191(43.8)	105(24.1)	63(14.4)
In the last month, how often have you felt that you were unable to control the important things in your life?	33(07.6)	90(20.6)	165(37.8)	81(18.6)	67(15.4)
In the last month, how often have you felt nervous and stressed?	24(05.5)	63(14.4)	169(38.8)	107(24.5)	73(16.7)
In the last month, how often have you felt confident about your ability to handle your personal problems?	19(04.4)	41(09.4)	147(33.7)	175(40.1)	54(12.4)
In the last month, how often have you felt that things were going your way?	29(06.7)	64(14.7)	179(41.1)	125(28.7)	39(08.9)
In the last month, how often have you found that you could not cope with all the things that you had to do?	31(07.1)	101(23.2)	192(44.0)	79(18.1)	33(07.6)
In the last month, how often have you been able to control irritations in your life?	38(08.7)	63(14.4)	160(36.7)	130(29.8)	45(10.3)
In the last month, how often have you felt that you were on top of things?	43(09.9)	113(25.9)	169(38.8)	86(19.7)	25(05.7)
In the last month, how often have you been angered because of things that happened that been outside of your control?	25(05.7)	67(15.4)	188(43.1)	107(24.5)	49(11.2)
In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?	40(09.2)	98(22.5)	173(39.7)	84(19.3)	41(09.4)

Supplementary Table 2.

Academic Anxiety among Study Participants assessed by Academic Anxiety Scale (AAS)

Items	Academic Anxiety Scale (AAS)
	Not at all typical of me n (%)	Somewhat typical of me n (%)	Quite typical of me n (%)	Very typical of me n (%)
I often worry that my best is not as good as expected in school.	123(28.2)	157(36.0)	84(19.3)	72(16.5)
I tend to put off doing school work because it stresses me.	152(34.9)	167(38.3)	79(18.1)	38(08.7)
I often worry that I am not doing assignments properly.	168(38.5)	141(32.3)	98(22.5)	29(06.7)
I am less confident about school than my classmates.	215(49.3)	114(26.1)	76(17.4)	31(07.1)
I have sense of dread when I am in my classroom.	226(51.8)	122(28.0)	66(15.1)	22(05.0)
I tend to find my instructors intimidating.	184(42.2)	157(36.0)	73(16.7)	22(05.0)
I spend much of my time at school worrying about what is next.	202(46.3)	121(27.8)	76(17.4)	37(08.5)
There is something about school that scares me.	238(54.6)	88(20.2)	73(16.7)	37(08.5)
I’m concerned about what my classmates think about my abilities.	215(49.3)	124(28.4)	69(15.8)	28(06.4)
I often feel sick when I need to work on a major class assignment.	227(52.1)	109(25.0)	76(17.4)	24(05.5)
I have a hard time handling school responsibilities.	207(47.5)	127(29.1)	68(15.6)	34(07.8)

Supplementary Table 4.

Item-wise analysis of Self-Efficacy among Nursing Students

Items	Strongly agree n (%)	Agree n (%)	Neutral n (%)	Disagree n (%)	Strongly disagree n (%)
Q1. I feel confident about capabilities that with little efforts I can resolve difficult problems.	91(21.1)	187(42.9)	129(29.6)	20(4.6)	8(1.8)
Q2. I am confident that I can achieve all the targets that I set for myself.	60(13.8)	200(45.9)	146(33.3)	27(6.2)	3(0.7)
Q3. I can finish task on time.	65(14.9)	184(42.2)	141(32.3)	44(10.1)	2(0.5)
Q4. Despite hard work, I feel I will not succeed.	19(4.4)	91(20.9)	142(32.6)	133(30.5)	51(11.7)
Q5. I feel I can keep self-control even at difficult time.	72(16.5)	188(43.1)	116(26.6)	47(10.8)	13(3.0)
Q6. In any circumstance, I can achieve what I desire.	52(11.9)	142(32.6)	189(43.3)	46(10.6)	7(1.6)
Q7. I have enough self-confidence to finish any work.	79(18.1)	204(46.8)	123(28.2)	25(5.7)	5(1.1)
Q8. With my efforts, I can achieve anything.	122(28.0)	199(45.6)	103(23.6)	10(2.3)	2(0.5)
Q9. My own potential and capabilities are responsible for all my achievements so far.	129(29.6)	191(43.8)	103(23.6)	12(2.8)	1(0.2)
Q10. It is usually not possible for me to achieve my targets.	10(2.3)	69(15.8)	131(30.0)	149(34.2)	77(17.7)
Q11. I am able to balance myself even in most difficult times.	72(16.5)	165(37.8)	138(31.7)	49(11.2)	12(2.8)
Q12. I am unable to face difficulties without any help and support.	21(4.8)	82(18.8)	164(37.6)	133(30.5)	36(8.3)
Q13. Even in most difficult situations, I can strategize to resolve and deal with it.	60(13.8)	185(42.4)	163(37.4)	23(5.3)	5(1.1)
Q14. I try my best to achieve my targets.	104(23.9)	194(44.5)	101(23.2)	31(7.1)	6(1.4)
Q15. I can keep my cool even when others try to fight with me.	80(18.3)	144(33.0)	138(31.7)	58(13.3)	16(3.7)
Q16. If I get stuck in some work, with little efforts I can resolve it.	45(10.3)	174(39.9)	171(39.2)	40(9.2)	6(1.4)
Q17. If I try sincerely, I am confident I shall be able to succeed.	136(31.2)	204(46.8)	79(18.1)	11(2.5)	6(1.4)
Q18. Despite concentrating on my aim, I will fail.	26(6.0)	64(14.7)	104(23.9)	130(29.8)	101(23.2)
Q19. If I am determined to succeed, I shall able to achieve success.	130(29.8)	200(45.9)	73(16.7)	27(6.2)	6(1.4)
Q20. If I work as per plan, I shall be able to reap result quickly	131(30.0)	176(40.0)	105(24.1)	14(3.2)	10(2.3)

Conclusion and Recommendations

The findings of this study concluded that the significant number of study participants experienced procrastination, which was strongly associated with higher levels of stress, anxiety, and lower academic performance and self-efficacy. Regular yoga/meditation and studying in the morning appeared to have a protective effect. Addressing these factors is essential not only for academic success but also for cultivating long-term professional resilience and well-being in the nursing field. Based on the study findings, an “Academic Procrastination Model for Nursing Students” was developed to emphasize the interventions to promote healthy behaviors, effective time management, and stress reduction, as conventional strategies may be insufficient.

Supplementary Table 3.

Item-wise analysis of Reasons of Procrastination among Nursing students

Items	Not at all reflects why I procrastinated n (%)	Slightly reflects why I procrastinated n (%)	Somewhat reflects why I procrastinated n (%)	Mostly reflects why I procrastinated n (%)	Definitely reflects why I procrastinated n (%)
Q19.You were concerned the professor wouldn't like your work	143(32.8)	79(18.1)	153(35.1)	35(8.0)	26(6.0)
Q20.You had a hard time knowing what to include or what not to include	70(16.1)	83(19.0)	164(37.6)	69(15.8)	50(11.5)
Q21. You waited until a classmate did his, so that he could give some advice	113(25.9)	78(17.9)	143(32.8)	61(14.0)	41(9.4)
Q22.You had too many other things to do	62(14.2)	82(18.8)	128(29.4)	91(20.9)	73(16.7)
Q23.There's some information you needed to ask professor, but you felt uncomfortable	120(27.5)	79(18.1)	119(27.3)	67(15.4)	51(11.7)
Q24.You were worried you would get a bad grades	123(28.2)	85(19.5)	138(31.7)	56(12.8)	34(7.8)
Q25. You resented having to do things assign by others	142(32.3)	95(21.8)	142(32.6)	38(8.7)	20(4.6)
Q26.You didn't think you knew enough to write the paper	119(27.3)	112(25.7)	126(28.9)	54(12.4)	25(5.7)
Q27.You really disliked writing term paper	118(27.1)	72(16.5)	138(31.7)	49(11.2)	59(13.5)
Q28.You felt overwhelmed by the task	81(18.6)	111(25.5)	145(33.3)	61(14.0)	38(8.7)
Q29.You had difficulty requesting information from others	112(25.7)	92(21.1)	147(33.7)	60(13.8)	25(5.7)
Q30.You looked forward to excitement of doing this task at last min	132(30.3)	102(23.4)	121(27.8)	49(11.2)	32 (7.3)
Q31.You couldn't choose all the topics	119 27.3)	91(20.9)	152(34.9)	45(10.3)	29(6.7)
Q32.You were concerned that if you did well, your classmates would resent you	168(38.5)	106(24.3)	105(24.1)	37(8.5)	20(4.6)
Q33. You didn’t trust yourself to do a good job	173(39.7)	91(20.9)	115(26.4)	32(7.3)	25(5.7)
Q34.You didn't have enough energy to begin the task	92(21.1)	92(21.1)	146(33.5)	62(14.2)	44(10.1)
Q35.You felt it just takes too long to write a term paper	94(21.6)	74(17.0)	169(38.8)	52(11.9)	47(10.8)
Q36.You liked the challenges of waiting until the deadlines	141(32.3)	100(22.9)	123(28.2)	34 (7.8)	37(8.5)
Q37.You knew that your classmate hadn't started the paper either	104(23.9)	94(21.6)	157(36.0)	52(11.9)	29(6.7)
Q38.You resented people setting deadlines for you	138(31.7)	110(25.2)	127(29.1)	31(7.1)	30(6.9)
Q39.You were concerned you wouldn't meet your own the expectations	113(25.9)	108(24.8)	122(28.0)	58(13.3)	35(8.0)
Q40.You were concerned that if you got good grades, people would have high expectations from you in future	149(34.2)	86(19.7)	115(26.4)	48(11.0)	38(8.7)
Q41.You waited to see if professor would give you some more information about the paper	120(27.5)	99(22.7)	130(29.8)	48(11.0)	39(8.9)
Q42.You set very high standards for yourself and you worried that you wouldn't meet those standards	102(23.4)	111(25.5)	133(30.5)	39(8.9)	51(11.7)
43.You just felt too lazy to write a term paper	95(21.8)	93(21.3)	128(29.4)	62(14.2)	58(13.3)
Q44. Your friends were pressuring you to do other things	174(39.9)	94(21.6)	107(24.5)	34(7.8)	27(6.2)

Funding Statement

The authors declared that this study has received no financial support.